GRAND PRIORY OF ENGLAND
AND
BRITISH ASSOCIATION
SOVEREIGN MILITARY ORDER OF MALTA

REPORT

FOR THE YEAR ENDED
31ST DECEMBER 2002


The Brotherhood of Blessed Gerard - Responding to AIDS
in Mandeni, KwaZulu Natal, Republic of South Africa

This article is written by our confrere Jim Little. He is a Seminarian for the diocese of Hexham and Newcastle studying at Ushaw College, Durham.

The relief organisation of the Order in South Africa is called the Brotherhood of Blessed Gerard. In June 2002 I had the opportunity to spend a month there on placement as part of my priestly formation. Pastoral placements during the summer vacation are an integral part of the formation programme. The Seminary is quite flexible about the type of pastoral work that we get involved in. Some students go into parishes while others get involved with other projects within their own diocese and some have the opportunity to go abroad.

I flew out to South Africa on 19th June. I was collected from Durban airport by Father Gerard Lagleder OSB, President of BBG and Mrs Clare Kalkwarf, Vice President of BBG, both of whom are known to our Lourdes pilgrims. They were both very welcoming, kind and cheerful people. We had a one-hour drive from the airport to the care centre and stopped off for lunch en-route. My first real experience of South Africa was lunch in a small pub in the seaside town of Ballito, sitting on the terrace in bright sunshine looking out onto the Indian Ocean. It was quite difficult to believe that this was the depth of winter in KwaZulu Natal. I am sure there was no deliberate attempt to deceive me but this first experience lured me into a false sense of the conditions I was to experience.


Celebrating the feast of the birth of St John the Baptist at Mandeni.

We arrived at the care centre in the middle of the afternoon. I was shown to my room and then taken on a whistle stop tour of the centre and introduced to everyone. The facilities within the care centre are very similar to those in hospices here in England. I had a relatively easy afternoon and evening meeting people and talking with them. Part of the induction for foreign volunteers is to ensure that they have a good understanding of the problems in the area and of the Zulu culture and tradition. The next two days were spent with Fr. Gerard and Clare learning about the culture and the locality, the do's and don'ts for my own safety and the care centre routine. I was also taken out into the bush to see the poverty stricken areas where most of the care centre patients come from. This was a stark contrast to the lunch I had experienced on the day of my arrival.

The following day, Saturday, we celebrated the feast of the birth of St John the Baptist. Fr. Gerard, Clare Kalkwarf and myself were the only members of the Order present. A small number of members of the Venerable Order were present from Durban, mainly representatives from their National Headquarters. Afterwards a very pleasant luncheon was served and Clare Kalkwarf gave a presentation on the work of BBG. After the celebrations were over we returned to my preparation for working in the care centre.

The town of Mandeni has one of the highest incidences of HIV in the world. During a recent study it was identified that 88% of the people tested are found to be HIV+. The reasons for this high incidence of HIV can ultimately be traced back to poverty. The Zulu people have a tradition of polygamy. Most Zulu men would have 5 or 6 wives. Due to extreme poverty in the KwaZulu Natal region the majority of Zulu men cannot afford to buy their wives. As a result of these financial difficulties formal marriages generally do not take place any more. Instead informal arrangements are made between men and women.

The Zulu woman will often find herself living as a single parent, with her various children. A man will want to arrange to see her on a regular basis, for this he will agree to pay for part of her living costs, i.e. rent, electricity, food or schooling for the children. The woman will have similar arrangements with five or six men. Moreover, the men will have these arrangements with five or six women and will occasionally engage in a one-off transaction with other women. It is easy to grasp why the HIV virus has spread so quickly amongst the Zulu community.

What does this mean for the Zulu people of Mandeni? Death is now an everyday occurrence. Initially the Zulu people were in denial. HIV and AIDS was considered to be a `White man's disease.' It is projected that by the year 2010 Mandeni will be a ghost town, all of the Zulu population will be dead without any major intervention.

The BBG care centre was built to provide a caring environment to allow the people of Mandeni to `die with dignity'. The centre was not planned as a response to the problem of HIV and AIDS. It was built to care for people suffering from any terminal illness. Unfortunately most of the people in the locality are dying of AIDS related illnesses today.

The care centre was purpose built for hospice care. The layout and design is the closest I have ever seen to resemble the first hospital in Jerusalem, built by Blessed Gerard Tonque, the founder of our Order. This is not surprising given that Fr Gerard Lagleder has carried out extensive research on Blessed Gerard and published a book ; `Blessed Gerard Tonque and his "Everlasting Brotherhood" The Order of St. John.' All of the wards are named after Saints or Beatified members of the Order. Inside each ward there is a print of the saint and text from the British Association Missal describing the person. Currently there are nine wards in the care centre. The wards are named as follows: 1, Blessed Raymond du Puy; 2, St Toscana; 3, St Nicasius; 4, St Hugh; 5, Blessed Peter; 6, St Flora; 7, Blessed Adrian Fortescue; 8, Blessed Gerland and 9, St Ubaldesca.

Volunteers from the local area staff the care centre; there is a very small number of employed staff. The volunteers make a considerable effort to get to the care centre. Public transport is very poor; the main form of transport is the local taxi service. This is a hybrid service generally provided in 12 seat mini¬buses operating on pre-determined routes. One often sees the mini-bus seriously overloaded and the level of maintenance and safety is very questionable. Volunteers will often spend in excess of one hour walking to a main road to take a taxi to Mandeni and will then walk to the care centre. This alone is very humbling when we consider our own attitude towards travel in this country.

Once in the care centre the staff look after every need of the patients, this involves bathing, feeding and sitting talking with them. The typical day in the care centre begins at 7am patients are woken up and given the opportunity to attend Mass in the care centre Chapel. All of the Feasts and Memorias of the Order are celebrated using the BASMOM missal. Patients are taken to the chapel on foot, in wheelchairs or in their bed according to their individual needs. After Mass breakfast is taken to each patient in the wards. After breakfast all of the patients are washed and their clothes are changed. The remainder of the morning is spent talking with the patients and cleaning the wards. Lunch is served at 1pm. The afternoon is spent talking with the patients and assisting them with their needs. The care centre was having a major extension added to it whilst I was there. The building work prevented the patients from spending the pleasant sunny afternoons on the terrace. An evening meal is served at 5.30. After this meal patients are settled down for the evening, the night shift volunteers come on duty at 7 in the evening.

I was aware of the fact that AIDS is a disease that attacks the immune system making sufferers more prone to infections. I was not prepared for patients not having access to painkillers and other drugs. The majority of the patients admitted to the care centre had AIDS, tuberculosis, a sexually transmitted disease and oral thrush. Drugs are available for the treatment of tuberculosis and sexually transmitted diseases. The drugs that are readily available in the UK for AIDS patients are not available in Mandeni quite simply because of cost. As a direct result of this many patients suffer much more than they would in the UK. It was quite shocking to see patients hallucinate, have epileptic fits and strokes and not have the appropriate medication available to provide even a temporary relief for them. Even painkillers are in short supply.

It is most common for care centre staff to go out in the afternoon to assess potential patients for admission to the care centre, although some assessments take place, at rather short notice, any time of the day. An assessment usually involves driving out into the bush. This is a real trial of one's driving skills. Once off the main road the dirt tracks are usually in terrible conditions. The Zulu people don't always build their homes adjacent to the beaten track, so some serious off road conditions are often experienced. In the bush most homes do not have running water or sewage facilities. People have to walk quite a distance to collect fresh water.

Patients are assessed and a decision is made to admit them based on their condition, the availability of resources in the care centre and the availability of assistance in their home. Because of the high number of people suffering from AIDS, it is not always possible to admit every patient visited for assessment. This is one of the reasons for the expansion of the care centre.

Fr. Gerard and I went out to assess a lady who had `had a stroke', the Zulu people refer to any loss of strength or movement as a stroke, we did not really expect to visit a stroke patient. We were given directions to the location as follows: `Cross the bridge and turn left at eBhananeni-Stop.' Fr. Gerard thought that this was the name of a village. We drove up and down the road a few times asking for this place and were told we had passed it. eBhananeni-Stop turned out to be a lay-by, it translates literally as Banana Stop. It was the lay-by where the cars stop next to the Banana Tree. Finding locations in the bush is often interesting and challenging but eBhananeni¬Stop was one of the more humorous challenges.

The care centre was originally opened to meet the needs of the terminally ill. Very soon after opening it inadvertently found itself looking after children. Some of the children have been admitted because they are HIV+; other children are in the care centre because they came in with their dying mother. AIDS orphans are unfortunately becoming quite common in the Mandeni area. It is estimated that there are in excess of 500,000 AIDS orphans in KwaZulu Natal. BBG is responding by building a dedicated floor on top of the care centre as a home for the children. Not all of the children in the care centre are orphans, some have suffered various forms of abuse and others have simply been abandoned.

The children who are not sick have a full programme each day. The older children go to school; BBG pays the school fees for these children. The younger children are looked after by care centre staff and have a play area with swings, a slide and a climbing frame. They currently live in some of the smaller wards of the care centre. Once the building work is completed the children will be looked after on a separate floor of the building. This will provide them with dedicated bedrooms, a lounge and recreation facilities. At the same time this will increase the capacity of the care centre for AIDS patients.

BBG also runs an AIDS education programme, a malnutrition clinic for babies, a pre-primary school crèche and a community development programme.

The main focus of my work in Mandeni was in the care centre working with AIDS patients and with the children. I very quickly realised that BBG responds to the needs of everyone irrespective of race, colour, creed or ability to pay. The families of patients are asked to make a donation to the care centre only if they are able to do so. Quite often families will donate a bag of fruit or a bottle of milk, and these donations are always gratefully received. It was a great privilege for me to experience the wonderful work of this organisation in the most tragic of circumstances. For me personally, the opportunity to give what little help I could, as member of the British Association, to some of the poorest and most unfortunate people in the world was a great privilege and a truly life changing experience. I really did feel that I was responding to what we are told in St Matthew's Gospel, `As you did it to the least of these my brethren you did it unto me.' (Mt 25:40).

With regard to the AIDS pandemic in South Africa and the work of BBG my attention was drawn to a comment in a book I was reading on ethics in relation to AIDS prevention that brought me back to the North East of England. `Outside many churches in the north of England there is a notice which reads: "The Millennium is Christ's 2000th birthday. Worship him-here-now." In this time of AIDS a more challenging message might be: "The Body of Christ has AIDS. Worship him - here - now." This stark message made me realise how important the work of BBG is to the people of Mandeni. Moreover, I realised that AIDS is a problem that requires a response from all Christians. The management and volunteers of the care centre are truly an example to us all in responding to the AIDS pandemic. They are responding fully to the fact that the Body of Christ has AIDS and they are not only worshipping him, they are serving him at the time of greatest need.

BBG regularly accepts foreign volunteers. Naturally, they are very experienced at providing a very welcoming environment and everyone is extremely hospitable. There is always a formal welcome and a formal farewell for foreign volunteers. At my farewell I took the opportunity not only to express my gratitude for the hospitality and kindness of everyone towards me. I took the opportunity to express my pride, gratitude and appreciation of all of the local volunteers. I really did find it so moving to find so many of these people, who are suffering the effects of poverty themselves, giving so much in the name of BBG and the Order. The experience of their charity made me so proud to be a member of the Order of Malta.

I would like to place on record my appreciation of the Grand Priory of England, the President and the Pastoral Department at St Cuthbert's Seminary Ushaw, the Brotherhood of Blessed Gerard and of Bishop Ambrose Griffiths OSB for making this experience possible. I am greatly indebted to them all for their support and encouragement.

If you would like to know more about the work of BBG please visit the web site at: http:// www.smom-za.org/bbg


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